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Discussion in 'Medical Topics' started by bnt83, Jan 10, 2017.
We're getting there...
already a thread, now we gotta read two threads.
Brian, this was MADE for YOU (& Dr. S).
I've already talked to him about it.
When do the new rules go in to effect?
May 1, 2017 (per the link in post #1).
Also Advisory Circular 68-1. There will be a Part 68 regulation but it has not been posted as of today.
Dr Bruce, I have a question about the basic medical form. I've had a medical certificate for most of the years since 1970, so I enter a lot of prnc notations explaining the various questions regarding my history.
Do you know if I can do that on the Basic Medical form?
I was wondering the same thing ... also if I could remember what the heck I said on the original exam before the boxes became PRNC ... but then I found my FAA MED file/folder and had my copies all the way back to the first one (well, first one second time around ... I have no records of my first/first back in 1978)
The only reason that we are allowed to put PRNC on the class three and higher medical applications is that the instructions say so. I haven't found anything like that in the new instructions (although I could have missed it). I don't think it would make sense, because I don't see how the fact that you previously reported something to the FAA would help your primary care doc decide if you're healthy enough to fly.
The text of Part 68 is near the end of this document:
(The link to that document appears on this FAA news release: https://www.faa.gov/news/updates/?newsId=87125)
Well, if a pilot came to me with PRNC on a Basic Med, would quiz him pretty good and probably ask for records. Why? I have no idea what has previously been reported and I am signing my name on an affidavit. How can I sing the signoff without knowledge of conditions?
Now if you were going to the same AME that you went to for 19 years and it was all reported through him, that's another matter. Do NOT expect the family doc to obtain and review your FAA Blue Ribbon Medical record to find out WTH is up. You can't run an office that way and survive.
To pre empt the question, can you remind us how we can order this file? I'm thinking I just might do that for my doctor since he is one that likes having the additional records when available.
And while you're sharing this, how can I get a copy of my SI letter. I neglected to put the last one in my records binder and as a result, it's gone missing.
So it's almost decision time. Do I renew my Class 3 or go BasicMed.
If going BasicMed, does my last Class 3 count for the 4yr comprehensive review? And for the next 2yrs I only need the online medical course?
No, your FAA issued medical certificate does not substitute for a comprehensive medical exam.
Write an original signature letter to Librarian, CAMI, PO Box 26200, Oklahoma City, OK 73125, request a copy and promise to be responsible for certified charges. Do NOT remove the punched/sealed ribbon if you want your doc to know that you have made no deletions. Sad, but that's how the world is.
Your SI letter will be in there.
Renewed my Class 3 this week. Easy peasy.
We're happy for you.
Wish it was so easy for me...
I'm up for renewal this summer, and thinking about the direction to go... my primary Doctor is against flying.... along with motorcycles, snowboarding, snowmobiles, quads, Jeeps, anything motorized actually... and shooting sports!... so it is a no go with him for the new process...
I guess I need to find an older, fat, gun shooting, off-roading, airplane flying Doctor!... Anyone in So Cal fit that role??...
Will most likely go back to the AME that did my last 3rd class and re-up....
I was in a seminar about BasicMed yesterday - the biggest difference is, that we don’t have to go to an AME anymore, but can now use your regular doctor.
This might or might not make things easier for us:
- The doctor and the pilot have to sign a document (and put his butt on the line for it), stating that you can safely operate an aircraft.
- Based on which standards will he make such a call? If he (and the pilot) is smart, he’ll use the same guidelines a for the Class 3 Medical. If he has no clue about flying or opposes it, he might even apply much stricter standards. If he’s stupid, he will just sign it, no matter of your medical condition. Insurance companies and lawyer will quickly go after him, if something happens.
- Pilots cannot fly outside the US with BasicMed.
- Anybody under 40 will certainly be better off by simply getting a 3rd Class medical.
- A pilot over 40, who needs to renew their medical every two years, BasicMed might be a little bit less hassle, but not by much and only if he finds a doctor who is willing to confirm his airworthyness, without giving him too much trouble.
I have to admit that I was genuinely disappointed, when I learned about the details. Personally, I will simply continue to renew my medical. Once I become concerned that I might not be able to pass it anymore, I’ll go light sport.
Hey, Oliver, been a long time since I have seen you and Martina, This 60 year old pilot is hoping the Basic Med will make things a bit easier come next fall. With Diabetes 2, OSA and Aortic Stenosis is can be a trifle expensive to get the third class. I am curious but plan to start the conversation with Doc Bruce around July when I would normally start my quest for the annual SI route. For now I figure he is inundated with calls from us old farts. My PCP and Cardiologist have told me they are on board with the new regulations but we all know it is the insurance companies that rule the roost when it comes to what Dr's will and will not sign. As Bruce would say Sighhhh.
Yes, it already seems like 6Y9 was a long time ago. We’re certainly looking forward to seeing you guys again.
The doctor, who did the presentation, said that AMEs are allowed to consult pilots, outside of an ‘official’ medical examination. To have such an informal consultation with Dr. Bruce might indeed be a great idea.
Keep in mind though, that one must have had a class 3 medical in the last 10 years, which had not been revoked or denied, in order to qualify for BasicMed. I understand that in order to fly light sport, this requirements is pretty much the same, only that the last medical can be older than 10 years.
I certainly wish you good luck and hope that everything will turn out OK for you.
Wouldn't an AME be able to do a BasicMed signoff? Would they not want to? Why? Seems this would be a best route for an over 40 to go 4year vs 2 year renewal. No? Or is there some protection(for the AME) in the old process that is missing in BasicMed?
Dr. Chien was quoted $24,000 per year for an insurance policy that would cover BasicMed sign-offs, which is prohibitively expensive.
My suspicion is that since this is a new program, medical liability insurance companies don't have any data on what the loss rate will be, so they're quoting high in order to protect themselves.
Wow, so it seems we've gained nothing, unless we can find a gullible doc that didn't know enough to ask his insurance provider that question, and will sign. So Bruce would have to do 240 basic med signoffs a year to break even(at $100 each), doesn't sound profitable.
Or charge more.
I actually asked him this question. He said he could do it - as he generally agrees with the FAA guidelines for the class 3 medical, he would however apply them with a bit of common sense, just as he already does for the actual class 3 medical. From an examination perspective, the standards would therefore be pretty much the same.
He however didn't seem too excited about doing this, because of the legalities involved. If I understood him correctly, the responsibility whether somebody is fit to fly an airplane or not is currently mainly with the FAA - as an AME, he is pretty much only the extended hand of the FAA, following their guidelines for a medical examination. Much of the responsibility would be on the FAA's side, they would also defend him at court, if necessary.
With BasicMed however, the doctor is the one who needs to make the call if a pilot is safe to fly or not.
This means, that if a pilot crashes due to medical reasons, even though the AME followed the FAA's guidelines, the AME who issued a 3rd class medical, will be fine.
If the same accident happens with a pilot who flew with BasicMed, the doctor might be in hot water and will have to answer some tough question about how he could let the pilot fly with his medical conditions.
A couple factors on this piece of info: 1) it isn't clear that this is an "additive" cost just to cover this type of physical, or a cost for a much more comprehensive policy that includes this as part of it; 2) just as with any insurance policy, the selected policy limits may play a substantial role in the cost.
I'll let the info on this page speak for itself on what a typical policy would more likely cost:
I'm having trouble accepting the idea that the malpractice liability risks to sign of a BasicMed exam are comparable to similar to those of a heart surgeon.
There are many doctors out there who do physicals not just for DOT, but for hazardous materials operators as well. The HAZMAT exam is quite comprehensive and requires a doc to sign off that the individual has no medical limitations to doing their job. If any of you are having trouble finding a doc who will do a BasicMed exam, I suggest you look to one of these types of occupational medicine centers.
Just another data point. I previously posted my doc said she had no problem with it, and about the doc in my building who runs a bunch of Truck Stop DOT physicals. He is setting up to do them as a major initiative. He has the database from the FAA and if you live on Northern VA you'll be getting a card from him like the AME's send out.
Anyways I ran into my kids doc at a sports event last night. She's a non-current pilot. I asked her, she said she would have no problem but as a pediatrician didn't expect many (of course) I asked about insurance and she cracked up laughing. When I asked her what was so funny, she reminded me the last time I was in was for her to clear my daughter off the concussion protocol for a return to full contact. She opined her insurance agent would much prefer signing off pilots than that. She thought the risk was far lower than her normal exposure. Makes sense to me.
Maybe it's a regional thing, But I haven't run into any around here that are scared of them. Anyways, just another data point.
Just curious, since I used to live in your area, who the doctor was. My former AME was Dr. Gordon, but another excellent AME that I would trust is Dr. Pinnell from up MBS-way. Most others in the area, not so much. (You can PM me if you'd rather not post the name publicly; I won't divulge without your permission.)
The reason I ask is that if he painted the picture that the most important difference with BasicMed is that you can see your PCP for this instead of an AME, I completely disagree. To me, the most important difference is that it isn't the FAA that ultimately makes the decision to sign you off but a doctor that you can deal with face to face. That knife cuts both ways, of course, since all the liability rests on the doctor's shoulders and if he's as worried about that as some seem to be, might demand the same tests as OKC. But even then, I'd suspect it would be easier for most doctors to accept that a dx that hasn't been an issue for many many years was probably bogus, something the FAA is often loth to do. I think that anyone who has had to pay out multi AMUs for medically unnecessary tests to satisfy the FAA that they don't have a condition that COULD, with some very low probability, explain a symptom or finding, will consider this a very welcome change.
Also, in my personal case, since my PCP is an NP and doesn't meed the qualifications to do a BasicMed signoff, I'll probably end up going to an AME anyway for that. Still seems like a win to me.
Thanks. I went to www.faa.gov, and in the list of regulations it shows "Part 68 XXX"
Not to worry, I have my class 3 and I am current.
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Yes, it was Dr. Gordon who did the presentation. I also wouldn't necessarily say that he painted the picture that the only difference was AME vs. a regular Doctor, it was just the impression I gained. I also asked a few clarification question questions, like what he would do if I'd ask him for BasicMed instead of a class 3 medical, what he answered stating that he would apply the same standards.
As you pointed out, the liability rests with BasicMed much heavier on the doctor's shoulders than on those of an AME issuing a class 3 medical what can go either way. The doctor (who is most likely not familiar with FAA stuff) also has to fill in the pretty much exact same questionnaire as for a regular medical.
For somebody who knows that he / she will not be able to pass a regular medical and has a doctor, who is willing to fill in the paperwork and to accept the liability, BasicMed might be the solution. Keep in mind, though, that the pilot and the doctor still have to sign a document, stating that the pilot is fit to fly. I am wondering, though, what would happen if in case of an incident and the NTSB / insurance finds out that this was done despite of known preexisting conditions, which would have made a class 3 medical impossible!?
Personally, I will just continue to get a class 3 medical every two years vs. trying to convince a regular doctor to sign off on BasicMed and not being able to fly over Canada anymore.
Ah - okay, I wondered if he might have been the one. He's a good AME, one I'd put right up there with Dr. Bruce and would unhesitatingly recommend to anyone who has a difficult certification problem.
I wouldn't limit the advantages of BasicMed to someone who KNOWS they wouldn't pass a class 3. Anyone who is looking at a deferral and a decision by OKC might be better off going the BasicMed route if their condition isn't one that still requires a SI under BasicMed... since a denial will lock you out of flying under BasicMed and so carries the same jeopardy as for light sport. Also, I would disagree that the document says that the pilot IS fit to fly. The statement the doctor signs says that s/he KNOWS of no condition that was make the pilot unsafe to fly, after completing a checklist that is at least as comprehensive as the one for a class 3 exam. If a pilot crashes while flying under BasicMed and is found (by autopsy or by history) to have had a condition that MIGHT have caused incapacitation or impairment, is that enough to trigger liability? What if the NTSB probable cause finding does not mention any medical finding? What if the cause may have been medical but the pilot withheld critical information from the doctor, and/or the condition was such that it is unlikely to manifest signs that a competent doctor could be expected to uncover the condition during a similar exam? I'm not sure we know yet what it will take to put the doctor financially on the line. That said, the possibility of being sued is always there until the courts iron this all out, and getting dragged into court is undesirable from every standpoint (including financial), so a doctor might reasonably decline to take the chance of becoming the test case.
In short, I just don't think we know yet. Personally, I'm going to ask my AME if he will do BasicMed exams, and if he says no, start shopping around for a new PCP who is an MD. I fall into the category that I mentioned - I'm likely to be able to get a class 3 but it will be a deferral, so the decision will be with OKC, with all the jeopardy that entails. One question that I haven't seen asked is whether, now that an SI can be a one-time-only thing and the pilot can revert to flying under BasicMed after a year, the FAA might be more conservative in applying their standards for an SI. If SIs become harder to get for the same condition, that would be another reason to not roll the dice unless one absolutely has to.
And according to Bruce, a very long delay in getting an answer, for us non-revenue flyers.
Wife is a primary care doc, we have dinner once a week with another couple that are both PCP's. Asked last night their stance on signing. All said they'd have no problem. Said they sign sports physicals, do DOT exams, etc.
Ironically, my wife was the only one of the three that had any reservation at all... Luckily she isn't my doctor.
No intention of doing so, but I've mentioned before that there are plenty of paperwork Docs out there who sign anything for money.
My employer employs four very nice Docs, who haven't seen a live patient in decades, and they sign piles of drug screening paperwork digitally all day long. One is even a pilot.
It's one of our own IT features on our software platform. Got some nifty little scribble pads and the signature is digitized and stored and all they have to do is mouse click.
We also are in one of the completely exempt businesses in the medical biz from HIPAA. Many people don't even realize such exemptions exist.
We are TINY. There's whole massive organizations that do nothing but have Docs sign paper digitally all day. Yay computers.